J Korean Soc Microsurg.  2007 May;16(1):48-51.

Reconstruction of Greater Trochanteric defect using Lumbar Artery Perforator Free Flap: A Case Report

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, College of Medicine Seoul National University, Korea. psdreun@hanmail.net

Abstract

There could be several methods for trochanteric reconstruction including local flap, pedicled perforator flaps, free flap, etc. We performed greater trochanteric reconstruction with lumbar artery perforator free flap in some aberrant method. So we report this experience with review of literatures. A 42-year-old man visited our hospital with a large soft tissue defect in his left greater trochanteric area by traffic accident. The patient had wide skin and soft tissue defect combined with open femur fracture. During one month period of admission, he underwent femur open reduction and wound debridement four times. After that we planned thoracodorsal perforator free flap reconstruction. The flap was outlined as large as 20x15 cm and elevated in a suprafascial plane from the lateral border. During intramuscular perforator dissection, we found that two 1.5 mm diametered perforator vessels coursed inferomedially toward second lumbar region. Finally the flap became lumbar artery perforator flap based on second lumbar artery perforator as a main pedicle. After flap transfer, the perforator vessels were connected with inferior gluteal artery and vein microsurgically. The operation was successful without uneventful course. We found no significant postoperative complication and donor site morbidity during six months follow up periods. Lumbar artery perforator flap could be an alternative procedure for thoracodorsal perforator flap in some patients with anatomic variant features.

Keyword

Lumbar artery perforator; Thoracodorsal perforator; Greater trochanter

MeSH Terms

Accidents, Traffic
Adult
Arteries*
Debridement
Femur*
Follow-Up Studies
Free Tissue Flaps*
Humans
Lumbosacral Region
Perforator Flap
Postoperative Complications
Skin
Surgical Flaps
Tissue Donors
Veins
Wounds and Injuries
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